DEATH THRESHOLD: Your death threshold is a negative number equal to
your maximum hit points or your Constitution score (whichever is
greater). For example, if you have a maximum of 23 hit points, then your
death threshold is -23.

ALIVE: You are alive as long as your current hit points are above
your death threshold.

DEAD: You are dead if your current hit points are below your death
threshold. Dead characters automatically lose 1 hp per round.

DISABLED

Once you reach 0 hit
points you are considered disabled. A disabled character move at half
speed and may only take a partial action each round. Disabled characters
who perform a standard action (or any other strenuous action, such as
casting a quickened spell) take 1 hp of damage after the action.

While you’re disabled,
you must make a Fortitude save (DC 10 + the number of hit points below
zero) each time you take damage (including the damage which resulted in
you becoming disabled).If
you fail this save you fall unconscious.

Unless you have
stabilized (see below), you take 1 hp of damage per round while
disabled.

STABILIZED

TENDED CHARACTERS:
A disabled character can be helped with a first aid check (Heal, DC 15).
On a success, the character stabilizes and begins healing naturally.

UNTENDED CHARACTERS:
A disabled character without assistance who takes no action in a round
has a 10% chance of stabilizing. Even after stabilizing they may still
take additional damage, however: Each day they must make a 10% roll to
start healing naturally. If they fail this check, they instead suffer 1
hp of damage and must check again the next day

WAKING UP: Once
an unconscious disabled character has been stabilized, they have a 10%
chance of waking up each hour. An untended character (who has not
benefited from a first aid check) who fails to wake up also takes 1 hp
of damage with each failed check.

HEALING

NATURAL HEALING:
After a full night’s rest (8 hours of sleep or more), you recover 1
hit point per character level. Any significant interruption during your
rest prevents you from healing that night. If you undergo complete bed
rest for an entire day and night, you recover twice your character level
in hit points.

MAGICAL HEALING:
Magical healing spells are maximized (they always restore the maximum
possible number of hit points). Any magical healing automatically
stabilizes a character. A character unconscious as a result of their
injuries also wakes up as a result of magical healing.

RESURRECTION

There are no spells which return the dead to life (raise dead, etc.). However, even dead characters can benefit from
magical healing and are returned to life if their hit point total is
raised above the death threshold. After 24 hours of death, however, a
character is lost forever and cannot be returned to life.

GENTLE REPOSE: A gentle
repose spell temporarily stops the loss of hit points a dead
character suffers. It also extends the period of time in which a
character can be revived.

CONSTITUTION SCORE DAMAGE

Characters reduced to 0 Constitution are dead, but
still have whatever hit points were left to them. They still lose 1 hit
point per round until their Constitution is raised to at least 1. If
their hit points drop below their death threshold, it will be necessary
to raise both their Constitution and their hit points in order to return
them to life.

Note:
Clerics may spontaneously cast lesser
restoration, restoration, and greater
restoration spells as if they were cure spells.

DEATH
EFFECTS

Any special ability or spell that results in death
instead causes 4d6 points of Constitution damage. On a successful save,
the special ability or spell causes 2 points of Constitution damage
(instead of whatever effect a save would normally have).

MASSIVE DAMAGE THRESHOLD

There is no massive damage threshold.

DESIGN NOTES

These are my personal house rules for death and dying in 3rd Edition.
They weren't conceived all at once, nor were they designed to overcome
any kind of serious mechanical flaw in the system. Rather, they're a
slow accretion of various tweaks which I use to change the flavor of
death in the game.

THE UNDISCOVERED COUNTRY

The first set of changes I put into place was the removal of raise
dead, resurrection, and similar spells. The motivation here
was relatively simple: I don't like the revolving
door of death. Death is a powerful and dramatic event... unless, of
course, it happens at the gaming table. At the gaming table it's usually
a joke. Or, at worst, a minor inconvenience.

This problem of flavor goes beyond de-valuing the meaning of death.
With even a modicum of logical thought, it completely changes the nature
of the game world. At the most obvious level, you will never have a
story which begins "when the old king died in the Battle of Batok's
Pass". You also have to realize that assassination becomes almost
pointless: In such a world, the country doesn't go into mourning when
JFK is shot in Dallas... it criticizes him for being a narcissistic
slacker when he refuses to respond to the raise dead spell.

It gets more severe (and more bizarre) from there.

These kinds of thought experiments and what-if games can certainly
have interesting results. But I'll confess that I'm generally looking
for something that looks a bit more like Middle Earth and a lot less
like transhumanist fantasy (which sounds like a fascinating, albeit
largely untapped, sub-genre).

So I got rid of raise dead.

But this creates a new problem: It's a lethal game. And I like combat
to be risky. Combining risky combat with an absolute barrier between
life and death will result in a lot of new characters being rolled up.
The revolving door may be gone, but death still becomes de-valued
because players stop investing themselves in characters they know have
the life expectancy of tissue paper in a blast furnace.

More precisely, I didn't want to increase the actual lethality of the
game (measured in characters permanently removed from gameplay). Nor did
I want to decrease the challenges of the game. I needed to shift the
flavor without shifting the gameplay.

The solution was to re-imagine what the -10 hit point barrier meant:
It was still a death of the body, but not a departure of the soul. Thus,
clerics could use their divine healing to bring back even those whose
bodies had been punished beyond the point of natural healing.

The result is a mechanic that looks a bit more like an emergency room
resuscitation than Jesus rising from the dead.

This is a subtle change, but one that removes the flavor problems
that come from a hero's spirit constantly yo-yoing between this world
and the next.

LOW-LEVEL LETHALITY

For many years, this was the only change I made to the death and
dying rules. Playtesting did reveal a few problem areas that needed to
be dealt with, but for the most part these rules worked and worked well.

One early discovery was that Constitution damage had suddenly become
much more horrible. In the standard game, the difference between dying
from Constitution damage and dying from hit point damage was
non-existent: In either case, you needed a raise dead spell to
bring you back. But, under the new rules, hit point damage could simply
be healed through spontaneous casting whereas Constitution damage would
frequently require a prepared restoration spell... at which point
the character's moldering corpse would have accrued a huge tally of
negative hit points.

This led to the simple expedient of allowing clerics to also
spontaneously cast restoration spells.

The other effect of this rule change was to smooth out the
differences between low- and mid-level play. Using the standard rules,
low-level characters have a practical barrier between life-and-death.
While they might theoretically be raised from the dead, in practice the
party lacks the resources to afford a raise dead spell. Plus,
given the low-levels involved, there's a minimal investment in the
existing character and a minimal time commitment required to roll up a
new character.

And then, for a few levels, coming back from the dead becomes a
possibility, but an expensive one: The cost of getting the spell cast
will seriously deplete the party's resources.

And then death becomes a speed bump.

This is one of the things that leads to the perception that low-level
play is so much more difficult and lethal than high-level play: Not only
do you have a smaller pool of hit points and a smaller margin for error,
but the barrier between life-and-death still exists -- so death is death
and you're not coming back.

Under these house rules, on the other hand, this continuum is made a
little less extreme: Low-level characters can hit -10 and still be
brought back.

HIGH-LEVEL LETHALITY

Speaking of that -10 barrier, we come to a widely-recognized
shortcoming in mid- and high-level play: The tougher you become, the
more likely you are to die than you are to fall unconscious.

Why? Because, as the average damage inflicted by any given blow
increases, the chance that any given blow will catapult you directly
from positive hit points to negative hit points and death increases. For
example, if you suffer a blow for 5 hp there is no chance that you'll be
immediately killed by it. If you're suffering blows doing an average of
25 hp, on the other hand, the odds drastically increase for such an
opportunity.

The solution for this is to increase the number of negative hit
points a higher level character can suffer before actually dying. And
the simplest solution for this is to give everyone the same number of
hit points below 0 as they do above 0.

DECOUPLING DYING

Finally, I had a desire to decouple unconsciousness and dying. There
are a couple of reasons for this:

First, one of the shortcomings of the game has always been its
inability to handle a person's "dying words" or "final
effort". It's a literary classic: The dying man exerts just enough
energy to whisper, "Your mother yet lives!" or
"Rosebud!" or "From hell's teeth I spit at you!" Or
perhaps the dying heroine manages to hold onto the detonation device
until her companions have escaped. But, in the game, a dying character
is always unconscious -- and thus unable of uttering dying words, making
a final heroic gesture, or anything else. They can't even bandage their
own wounds.

Second, I've always liked the mechanics for being disabled: There's
something dramatic about a wound so severe that taking any strenuous
action is literally making your wounds worse. It forces a desperate,
bleeding retreat; or it offers the hero a chance to grit their teeth and
achieve something remarkable; or it leaves the villain staggering as the
hero surges forward for their triumph.

But, unfortunately, the disabled condition only happens when a
character lands precisely at 0 hit points. And then it only lasts for,
at most, a single round before they keel over into unconsciousness.

Both of these problems can be solved by decoupling dying and
unconsciousness, as shown in the house rules.

And, as ancillary benefit, this mechanic also allows the dying
condition to serve as a "warning track" of sorts. Instead of
just plugging away at full power until, suddenly, the character is
completely out of it, now a PC is more likely to enter the dying state and
be able to do something about it: Bind their wounds. Call out for the
cleric. Gulp down a healing potion.

THE PROBLEM OF UNCONSCIOUSNESS

One problem I haven't solved yet is the problem of unconsciousness.
More specifically, the problem of waking someone up who has been
unconscious.

In real life, if someone gets knocked unconscious you can frequently
(but not always) wake them up again by slapping them, throwing water in
their face, or waving smelling salts under their nose. In the game,
however, this doesn't work. If you've hurt someone enough to knock them
unconscious, the only thing you can do is either (a) magically heal them
or (b) wait a very long time for them to naturally heal some damage.

This is a shortcoming, as my players frequently want to model that
narrative conceit of slapping a prisoner awake so that they can question
them. (Ironically, this can only drive them deeper into unconsciousness
using the rules.) Unfortunately, I haven't figured out any particularly
good way (and a simple way) to overcome this shortcoming.